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General NPI Number Information
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NPI Number | 1235487372
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Entity Type | Organization
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Legal Business Name | THREE HEARTS THERAPY LLC
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Dates
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Enumeration Date | 08/21/2012
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 2424 JUAN TABO BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-1818
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Country | US
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Telephone | 505-503-1811
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Fax | 505-274-7338
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Provider Business Mailing Address
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Address Line | 2201 SAN PEDRO DR NE STE 100
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-4133
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Country | US
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Telephone | 505-503-1811
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Fax | 505-639-4309
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Authorized Official
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Title or Position | PROPRIETOR
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Name | ERIN M COLLINS
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Credential | LISW
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Telephone | 505-503-1811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I-6807
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License Number State | NM
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